Drawing on a Sculpted Space of Actions: Educating for Expertise while Avoiding a Cognitive Monster

Avoiding a Cognitive MonsterAlthough expertise is usually considered as a positive outcome of education and practice in domains as varied as sports, science, music and politics, there are also concerns about negative effects of expertise. Since expertise is facilitated largely by implicit, automatic cognitive and brain processes, it can also lead to undesirable consequences in the form of stereotypical, discriminatory or inflexible responses. Indeed, such responses can at times even be inconsistent with the explicit and intentional choices of an expert. Explaining this phenomenon, it is argued that an expert’s performance can be considered as selecting in a given situation a preferred option for action from a ‘Sculpted Space of Actions’ (Keestra, 2014), which contains more, more complex and better differentiated action representations than a beginner’s space of actions. Integrating this account with the cognitive neuroscientific theory of Predictive Processing, it is argued how mitigating undesirable effects of expertise depends upon awareness and control of the processes involved. Education should therefore provide for insights in and techniques for controlling the cognitive and brain processes that constitute expertise

Public Risk-Taking and Rewards During the COVID-19 Pandemic-A Case Study of Remdesivir in the Context of Global Health Equity

Public investment, through both research grants and universityfunding, plays a crucial role in the research and development (R&D) of novel health technologies, including diagnostics, therapies, and vaccines, to address the coronavirus disease 2019 (COVID-19) pandemic. Using the example of remdesivir, one of the most promising COVID-19 treatments, this paper traces back public contributions to different stages of the innovation process. Applying the Risk-Reward Nexus framework to the R&D of remdesivir, we analyse the role of the public in risk-taking and reward and address inequities in the biomedical innovation system. We discuss the collective, cumulative and uncertain characteristics of innovation, highlighting the lack of transparency in the biomedical R&D system, the need for public investment in the innovation process, and the "time-lag" between risk-taking and reward. Despite the significant public transnational contributions to the R&D of remdesivir, the rewards are extracted by few actors and the return to the public in the form of equitable access and affordable pricing is limited. Beyond the necessity to treat remdesivir as a global public good, we argue that biomedical innovation needs to be viewed in the broader concept of public value to prevent the same equity issues currently seen in the COVID-19 pandemic. This requires the state to take a market-shaping rather than market-fixing role, thereby steering innovation, ensuring that patents do not hinder global equitable access and affordable pricing and safeguarding a global medicines supply